Effects of pioglitazone on ovarian stromal blood flow, ovarian stimulation, and in vitro fertilization outcome in patients with polycystic ovary syndrome

• Published in: Fertility and sterility Vol. 94; no. 1; pp. 236 - 241
• Main Authors: Kim, Chung-Hoon, M.D, Jeon, Gyun-Ho, M.D, Kim, So-Ra, M.D, Kim, Sung-Hoon, M.D, Chae, Hee-Dong, M.D, Kang, Byung-Moon, M.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.06.2010; Elsevier
• Subjects: Adult; Biological and medical sciences; Birth control; Female; Female genital diseases; Fertilization in Vitro - methods; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Internal Medicine; Intraovarian stromal blood flow; IVF; Medical sciences; Non tumoral diseases; Obstetrics and Gynecology; ovarian stimulation; Ovary - blood supply; Ovary - drug effects; Ovary - pathology; Ovulation Induction - methods; PCOS; pioglitazone; Polycystic Ovary Syndrome - drug therapy; Polycystic Ovary Syndrome - physiopathology; Pregnancy; Prospective Studies; Regional Blood Flow - drug effects; Regional Blood Flow - physiology; Sterility. Assisted procreation; Stromal Cells - drug effects; Stromal Cells - pathology; Thiazolidinediones - pharmacology; Thiazolidinediones - therapeutic use; Treatment Outcome; Young Adult; IVF; Intraovarian stromal blood flow; pioglitazone; PCOS; ovarian stimulation; Human; Prognosis; Ovarian stimulation; Gynecology; Pioglitazone; Assisted procreation; Female sterility; Thiazolidinedione derivatives; Polycystic ovary; Obstetrics; Female genital diseases; Blood flow; In vitro fertilization embryo transfer; Ovarian diseases; Hypoglycemic agent; Cyst; Benign neoplasm
• ISSN: 0015-0282; 1556-5653
• DOI: 10.1016/j.fertnstert.2009.02.029

Objective To investigate the effects of pioglitazone on ovarian stimulation, in vitro fertilization (IVF) outcome, and intraovarian stromal blood flow in patients with polycystic ovary syndrome (PCOS). Design Prospective, randomized, controlled trial. Setting University-affiliated infertility clinic. Patient(s) Sixty infertile patients with PCOS resistant to clomiphene citrate. Intervention(s) An IVF protocol involving use of a gonadotropin-releasing hormone (GnRH) antagonist and oral contraceptive pretreatment. Patients were randomized into two groups: pioglitazone (30 mg daily) in the study group or placebo in the control group, commenced on the day on which oral contraceptive intake began. Main Outcome Measure(s) Ovarian stimulation, IVF outcome, and resistance index of the intraovarian stromal artery. Result(s) The resistance index value on the day of human chorionic gonadotropin (hCG) injection in the study group was statistically significantly higher in the study group than in controls. The serum estradiol level and number of retrieved oocytes were statistically significantly lower in women treated with pioglitazone. However, the number of mature oocytes and fertilized oocytes, and the clinical pregnancy rate were similar in both groups. Conclusion(s) Pioglitazone therapy reduced intraovarian stromal blood flow and might be beneficial in improving both the response to ovarian stimulation and IVF outcome in PCOS patients.